Small cell carcinoma of the prostate. Part I. A clinicopathologic study of 20 cases

Clinical information and histological slides of 20 cases of small cell carcinoma of the prostate seen at The University of Texas M. D. Anderson Hospital and Tumor Institute at Houston over a 23-year period were reviewed. Patient's ages ranged from 30 to 89 years (median, 67 years). In nine cases, pure adenocarcinoma of the prostate preceded recognition of the small cell component by 7 months to 8 years (median, 18 months); five of these were initially at Stage A. There was a small cell component at presentation in 11 cases (10, Stage D). Small cell carcinoma was merging with the adenocarcinoma in 11 cases and represented 30% to 90% of total tumor volume. Eleven of 20 patients died of their disease. Those presenting initially with a pure adenocarcinoma survived between 7 months and 9 years (median, 24 months). After the recognition of the small cell carcinoma component, regardless of a prior history of adenocarcinoma, death followed within 1.5 years (median, 5 months). This study suggests a biologic difference in behavior in prostatic carcinoma containing a small cell carcinoma component. The small cell component may manifest early or late in the disease.

Rat alkaline phosphatase. II. Structural similarities between the osteosarcoma, bone, kidney, and placenta isoenzymes

A mouse monoclonal antibody raised against rat osteosarcoma alkaline phosphatase (AP) was covalently coupled to protein A-Sepharose and used to purify this enzyme from preparations of rat osteosarcoma, calvaria, kidney, and placenta in a single-step procedure. The tissue-specific isoenzymes purified in this manner showed identity in the immunodiffusion reaction with a polyclonal anti-AP antibody, but differed in apparent molecular weight and degree of polydispersity on sodium dodecyl sulfate-polyacrylamide gels. Treatment with N-glycanase abolished these differences, yielding proteins with an apparent molecular weight of 52,000 Da and identical V8 protease digestion patterns. Alkaline phosphatase from these tissues showed no significant difference in amino acid composition and identity in the first 20 N-terminal amino acids. These findings provide structural evidence which supports the hypothesis that the tissue-specific alkaline phosphatase isoenzymes share a common protein sequence subject to different glycosylation pattern.

Udder edema in cattle: effect of furosemide, hydrochlorothiazide, acetazolamide, or 50% dextrose on venous blood pressure

Before injection of diuretic drugs, blood pressures were determined in the cranial superficial epigastric veins (milk vein) and jugular veins of 15 Holstein cows with udder edema at parturition and of 15 healthy (control) cows at parturition. Cows with udder edema had a significant (P less than or equal to 0.05) mean increase in cranial superficial epigastric venous pressure at parturition, compared with that of control cows. After IV administration of 500 mg of furosemide in cows with udder edema, the mean cranial superficial epigastric venous blood pressure significantly (P less than or equal to 0.05) decreased within 5 minutes, remained at the decreased pressure for 90 minutes, and then returned to near pretreatment pressures by 210 minutes after furosemide injection; however, furosemide did not significantly affect the jugular venous blood pressure of these cows. Furosemide injection did not significantly affect the cranial superficial epigastric or jugular venous blood pressure in the control cows. After IV administration of hydrochlorothiazide (250 mg), acetazolamide (500 mg), or 50% dextrose (500 g), the cranial superficial epigastric and jugular venous blood pressures in cows with udder edema at parturition were not significantly different from those in cows without udder edema at parturition during the 210-minute evaluation period after injection of the drugs.

Incidence, extent and location of unsuspected pelvic lymph node metastasis in patients undergoing radical cystectomy for bladder cancer

Between March 1, 1983 and December 31, 1985, 18 of 130 patients (14 per cent) undergoing radical cystectomy had unsuspected metastasis. In 17 patients (94 per cent) only 1 or 2 nodes were involved. The mean size of the involved nodes was 0.81 cm. and the mean size of metastasis was 0.39 cm. In patients with 1 or 2 positive nodes metastasis was not observed above the bifurcation of the common iliac arteries or lateral to the external iliac arteries. In patients in whom the primary bladder tumor was localized clearly to 1 side of the bladder unsuspected metastasis was observed only in ipsilateral lymph nodes. In accordance with these findings, we advocate a restricted pelvic lymphadenectomy in patients in whom gross examination reveals no evidence of nodal metastasis at radical cystectomy.

Use of human minor salivary glands in basic and applied secretion research

Previous findings from studies utilizing human labial and palatine minor salivary glands are reviewed. These studies took histopathological, biochemical, and ultrastructural approaches, and focused on control and diseased glands. Disease-oriented summarization are used, and control results are discussed in the context of disease-related findings. Findings are reviewed separately for electrolytes, macromolecules, and ultrastructure. In control subjects, minor gland salivary electrolyte concentrations are dependent on flow rate, and this dependence may be altered by diseases such as cystic fibrosis as well as by inflammatory situations such as graft-versus-host disease. There is also evidence that salivary electrolyte secretion processes are not similar in labial and palatine minor glands. Studies of salivary macromolecular composition are reviewed for control subjects and for patients with graft-versus-host disease and Sjögren's syndrome. The findings indicate that the macromolecular contents of labial and palatine gland saliva are similar, but that both are significantly different from that for major gland saliva. Finally, studies attempting to measure disease-related changes in intracellular composition are reviewed. It is concluded that the minor salivary glands are important models for the study of exocrine gland physiology and pathophysiology in man.

Level of alimentation and line of breeding on oxygen uptake by ovine jejunal mucosa

Targhee rams from a selected and control line of breeding were provided with the same diet at either 100 or 40% of ad libitum feed intake levels for 28 days. The rams were killed in a serial fashion over a 35-day period. A sample of the jejunum mucosa was taken, and O2 consumption rates with and without ouabain were measured. Total O2 consumption and ouabain-sensitive respiration rates of the jejunal mucosa taken from rams of the select line were greater than for samples taken from the control rams. Line of breeding did not influence the percent of the total O2 consumption that was ouabain sensitive and the proportion of the jejunum that was mucosa. Differences in rates of total and ouabain-sensitive O2 consumption attributed to level of feed intake were not detected as significant. Both the percentage of the total respiration rates that was ouabain sensitive and the proportion of the jejunum that was mucosa were greater for rams fed at high intake levels compared with rams fed at low intake levels. Thus both breeding sheep on the basis of improved growth potential and level of alimentation influenced aspects of jejunal mucosa respiration that was Na+-K+-adenosinetriphosphatase dependent.

Intracellular elemental concentrations in resting and secreting rat parotid glands

Electron probe x-ray micro-analysis was used to study the elemental concentration changes that occur during pilocarpine-stimulated saliva secretion. Quantitative x-ray micro-analysis of elemental concentrations in intracellular compartments of rat parotid glands stimulated in vivo with pilocarpine showed that Na concentration was significantly increased, while K concentration was significantly reduced. The magnitude of these changes was consistent with values obtained in other tissues with the x-ray micro-analysis method, and in the same tissue with other experimental methods. Comparisons with results from studies utilizing dispersed acini suggest that acinar dispersion procedures may affect intracellular elemental concentrations. Total electrolyte concentrations in cytoplasm and secretory granules were estimated to increase on a dry-weight basis following pilocarpine stimulation. The former change is consistent with the notion of a transcellular route of salivary fluid flow, while the latter change may be important in the exocytosis of secretory granules.

Effect of electric currents on DNA synthesis in rat osteosarcoma cells: dependence on conditions that influence cell growth

Effects of sinusoidal 60-Hz electric currents on DNA synthesis in rat osteosarcoma cell (ROS 17/2.8) in culture were investigated using agar electrodes. This exposure system eliminates electrochemical effects at electrode surfaces, minimizes the contribution of magnetic fields and produces no detectable temperature changes (less than +/- 0.1 degrees C) at current densities of up to 1,500 microA r.m.s. (root mean square)/cm2. Thirty-four hours exposure to electric current at intensities of 300-400 microA r.m.s./cm2 enhanced DNA synthesis by 20% relative to controls. The effect depended on serum concentration, cell seeding density, and the age of the cell population at the time of seeding: effects were seen at 0.2% fetal bovine serum, in cells seeded 4 days after previous passage, at 20,000 cells/cm2. These findings indicate that sinusoidal electric currents can midly enhance DNA synthesis in these cells under growth-limiting conditions.

DNA polymorphisms for the nerve growth factor receptor gene exclude its role in familial dysautonomia

Alleles for the single human nerve growth factor receptor gene (NGFR) on chromosome 17q can be distinguished by two polymorphic restriction sites for XmnI and one for HincII. The combined information content for haplotypes is quite high, making the NGFR locus an excellent genetic marker. Two of these polymorphisms were used to follow the inheritance of NGFR alleles in families with two or more members affected with familial dysautonomia. This rare disease is inherited in an autosomal recessive mode in the Ashkenazic Jewish population. Affected individuals show a severe depletion of NGF-dependent nerve populations from birth. Linkage analysis excluded a role for NGFR in this disease with odds of greater than 10(6):1 against the dysautonomia gene being within 1 centiMorgan of the mutation. In a previous study the gene for the beta subunit of NGF (NGFB) was also excluded in this disease. A possible role for other genes involved in NGF action or those coding for other developmentally determining neuronal factors is indicated.

Analytical electron microscopy in the study of biological systems

The AEM is a powerful tool in biological research, capable of providing information simply not available by other means. The use of a field emission STEM for this application can lead to a significant improvement in spatial resolution in most cases now allowed by the quality of the specimen preparation but perhaps ultimately limited by the effects of radiation damage. Increased elemental sensitivity is at least possible in selected cases with electron energy-loss spectrometry, but fundamental aspects of ELS will probably confine its role to that of a limited complement to EDS. The considerable margin for improvement in sensitivity of the basic analytical technique means that the search for technological improvement will continue. Fortunately, however, current technology can also continue to answer important biological questions.

Net energy value of ammoniated wheat straw

Eight steers (327 kg average) were fed diets containing either nontreated or anhydrous NH3-treated wheat straw in a two-period crossover design. Intake and digestibilities of dry matter, gross energy, neutral detergent fiber, acid detergent fiber and crude protein were measured by total collection. Energy losses in urine and methane were determined. Heat production was determined by indirect respiration calorimetry on steers fed both diets and after they were fasted. Ammoniation of the straw raised its N content from .49 to 1.59% (P less than .001). Dry matter (DM) intake was increased (P less than .01) by the process from 1.0 to 1.3% of body weight. Digestibility coefficients of dry matter and energy, as well as those for fiber, were increased (P less than .001) by four percentage units or more. Crude protein digestibility, however, was depressed (P less than .001) from 67.8% to 53.5% by ammoniation. Urinary energy as a percentage of gross energy intake (GEI) was reduced (P less than .05) by NH3 treatment from 4.10 to 3.74%. Methane energy was not different (P greater than .10). Metabolizable energy was improved (P less than .001) by ammoniation, increasing from 45.2 to 50.0% of GEI. Daily heat production was higher (P less than .01) for steers consuming the ammoniated straw diet, increasing from 113.7 to 125.3 kcal/wt.75), and was due to higher metabolizable energy intake (MEI) since partial efficiency of MEI used for maintenance did not differ (P greater than .10) between diets. The higher net energy value of the ammoniated wheat straw diet (1.45 vs 1.26 kcal/g DM) was due mainly to decreased fecal loss and a slight decline in urinary loss.

Changes in elemental concentrations of rat parotid acinar cells following pilocarpine stimulation

1. Quantitative electron microprobe analysis was used to measure elemental dry weight concentrations in cytoplasm, secretory granules and nuclei of resting and pilocarpine-stimulated rat parotid gland acinar cells. 2. Secretory granules in resting cells had lower concentrations of Na, Mg, P, Cl and K, and higher concentrations of S and Ca than cytoplasm or nuclei. Nuclei in resting cells had lower S and higher K concentrations than cytoplasm. 3. Three major pilocarpine-related changes were found: (i) cytoplasmic dry weight concentrations of Na and Ca increased and the concentration of K decreased, (ii) the nuclear concentration of Na increased while that of K decreased and (iii) the concentrations of Na and Cl increased in secretory granules. 4. These results indicate that the nuclear, and cytoplasmic compartments have different mechanisms for regulating their elemental concentrations relative to the secretory granules. 5. The present results are largely consistent with X-ray microanalysis results from the pilocarpine-stimulated dog submandibular gland.

Beam induced mass loss in high resolution biological microanalysis

Electron beam induced loss of mass from the organic matrix and from higher Z constituents of biological samples was measured by monitoring bremsstrahlung and peak changes in EDS spectra. When any effects of contamination, extraneous X-rays, beam current drift, specimen drift, and specimen shrinkage were monitored and corrected for, the three types of samples gave consistent and similar results at 296 K. Bremsstrahlung losses averaged 45%, 46% and 50% respectively for muscle homogenate, salivary gland sections and albumin. Sulphur losses average 74%, 72% and 86% for the same three sample types. No other elements suffered significant losses. D1/e for bremsstrahlung averaged 0.14 C/cm2. Bremsstrahlung loss at 93 K began approximately one order of magnitude higher in dose, and the extent of loss varied. Sulphur losses, however, were greatly reduced at low temperatures.

Clear cell cribriform hyperplasia of prostate. Report of 10 cases

We report 10 patients with clear cell cribriform hyperplasia of the prostate. Their ages ranged from 62 to 87 years, with a mean of 72 years. The clinical diagnosis in all patients was benign nodular hyperplasia; all the patients are alive and have shown no evidence of recurrent disease. Follow-ups ranged from 1 month to 7 years (median: 12.5 months; mean: 24.6 months). Pathologically, this lesion has a cribriform arrangement of clear cells with a complex papillary growth simulating the cribriform pattern of prostatic carcinoma. In fact, in five of the 10 cases, the referring diagnosis was either carcinoma or possible carcinoma. Cytologically, however, there is no nuclear atypia, mitosis, or prominent nucleoli, and typically there is a double epithelial cell layer at the periphery of the involved acini. In summary, clear cell cribriform hyperplasia is a benign hyperplastic process with a complex papillary-cribriform structure and should not be confused with prostatic carcinoma. The key feature for the diagnosis is the preservation of nodular configuration with a bland cytology and double cell layer lining the involved acini.

Preclinical trials with combinations and conjugates of T101 monoclonal antibody and doxorubicin

We investigated the potential for additive therapy for malignancy using an anti-human T-cell monoclonal antibody, T101, and the chemotherapy agent doxorubicin (DOX). We compared the efficacy of T101 alone, DOX alone, T101 and DOX covalently linked to dextran to form an immunoconjugate, T101 plus DOX mixed together and injected, T101 and DOX injected separately, and nonspecific murine IgG2A plus DOX mixed together. Inhibition of [3H]thymidine was examined in vitro, and the clinical efficacy of each treatment was tested on human T-cell tumors growing in athymic mice. In vitro experiments confirmed retention of immunoreactivity and cytotoxicity by the immunoconjugate, but it was not superior to DOX alone. In efficacy experiments, all therapeutic arms were superior to placebo treatment (P less than 0.05). However, the best results in the animal tumor model were obtained with T101 mixed with DOX, perhaps because of formation of weak complexes via hydrophobic bonds. This mixture was superior to all other treatments, both by growth curve analysis (P less than 0.05) and by analysis of complete regression of tumor (P less than 0.01). T101 mixed with DOX was superior to a mixture of nonspecific mouse immunoglobulin and DOX and superior to a combination of T101 injected i.v. and DOX injected i.p. The antitumor effect of T101 mixed with DOX was blocked by premodulating the target antigen with T101. These data suggest that further exploration into monoclonal antibody-anthracycline complexes is warranted.

Nissen fundoplication for gastroesophageal reflux in infants

Some degree of gastroesophageal reflux is very common in infants and tends to reverse with time. Therefore, the indications for an antireflux operation are not well defined. Furthermore, the complication rate and the ability of the fundoplication to grow remain to be determined. To answer these questions, we reviewed the records of patients 6 months of age or younger who underwent a Nissen fundoplication with gastrostomy tube placement between 1979 and 1985. There were 45 patients (25 boys and 20 girls) with birth weights of 0.65 to 4.3 kg. The consequences of gastroesophageal reflux were more varied than in older children. Severe respiratory problems were common, including recurrent aspiration or bronchopulmonary dysplasia in 60% and frequent apneic and bradycardiac spells in 17%. Failure to gain weight was present in 20% and intractable vomiting in 2.0%. As expected, 78% of these patients had congenital anomalies or acquired problems which, in many cases, were important to the prognosis. The diagnosis was confirmed by barium swallow in all but one patient in whom gross reflux during feedings was present. Initially, medical management was tried for 3 to 4 weeks. In one patient, however, the severity of the respiratory problems precluded trial beyond 12 days. The recommendation for operation was based only on the severity of symptoms attributed to gastroesophageal reflux. All patients underwent Nissen fundoplication with gastrostomy tube placement at 2 weeks to 6 months of age and weighing 1.02 to 6.95 kg. The only surgical complication was one gastrostomy leak. Prematurity or preexisting anomalies led to a 20% incidence of late unrelated deaths between 2 weeks and 23 months postoperatively. Improvement in symptoms occurred in our survivors with follow-up of 5 to 72 months. We conclude: Significant gastroesophageal reflux in infancy most frequently produces respiratory problems that can be life threatening. Nissen fundoplication can be a safe and effective procedure in infants 6 months of age or younger. Fundoplication appears to have good growth potential, and no late complications or feeding problems have occurred. Consequently, surgical correction can be recommended for infants not responding to conservative medical therapy.